| NPI | 1154584266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CO DR.0048088) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO 48088) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2016-08-26 |